Infection Control

1
Infection Control Prevention A generic overview
of an
Infection Control Program

• How Does Infection Prevention Control
• fit into
• The Big Picture of our healthcare facility?

2
Infection Control (Epidemiology)

• The Study of Infection Control (IC) is grounded
  in Epidemiology
• Epidemiology The Study of Anything that happens
  to people
• EPI Upon
• DEMOS People
• LOGY -- Study

3
Where Did IC Come From? Where is IC Prevention
Going?

• 1840s with Dr. Semmelweis
• Handwashing
• Germ Theory Cemented 1930s
• Late 1950s Antibiotics
• Early 1960s Antibiotic Resistance
• Back to Handwashing Prevention
• 1970 1st isolation guideline published by CDC
• 1992 HICPAC formed to advise DHHS/CDC on
  infection prevention in healthcare facilities and
  develop guidelines
• Today Travel, Bioterrorism, Super Bugs,
  Community Participation

4
Were Called Many Things Even if we just do
Infection Control

• Nurse Epidemiologist
• Infection Control Practitioner
• Infection Control Professional
• Infection Control Coordinator
• Infection Control Manager
• Infection Control Director

5
We Work Many Places Resources are Varied

• Large University Teaching Hospital
• Non-Teaching Acute Care
• For Profit
  
• Non-Profit
• Medium Small Hospitals
• Non-Traditional Settings
• Hospital vs. Free-Standing non-hospital
  affiliated healthcare facilities

6
Non-Traditional ICP Settings affiliated with
Hospitals

• Ambulatory Clinics
• Day Surgery Centers
• Long Term Care Facilities
• Rehabilitation Services
• Home Care
• Dialysis Centers
• Transitional Care
• Physicians Offices

7
Setting Determines Resources

• Educational Sponsorship?
• Hardware? Software?
• Data Entry Secretary Support?
• Number dedicated to IC P?
• Non Revenue-Producing Department
• Multiple Hats?
• Risk Management, Employee Health, Nurse Educator,
  Quality Management, Utilization Review

8
How is an ICP Born ?

• APIC -- 1972
• LVN, RN, MT, MPH
• Formal Training
• APIC State IC Organizations
• 1-3 years to become proficient
• Ongoing Education
• CIC -- 1983
• Giving Back Sustaining the Profession
• Research and Publications
• Volunteerism
• Involvement with Public Policy

9
Infection Control Human and Fiscal Resources

• SENIC Study 19851 ratio of number of ICPs to
  patient beds 1250 Acute Care
• Before advent of clinics and off-site services,
  and extensive diversity complexity of services
• Delphi Study 20022 ratio 1100 (response to
  expanded responsibilities)
• CBIC task analyses of ICP job every 5 years
  1982-2002
• Infrastructure consensus recommendations
  1998,19993
• These studies assume Dedicated ICP and not a
  multi-tasker (wearing many hats)
• 1 Haley RW. Am J Epidemiol 1985 121 182
• 2 OBoyle C. AJIC 2001 30321
• 3 Scheckler WE. ICHE 1998 19114 Friedman C.
  ICHE 1999 20 695

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Not JUST Infection Control

• Microbiology
• Epidemiology
• Statistics
• Management
• Communications
• Employee Health
• Reportable Disease
• Plant Operations

• Education
• Sterilization
• Disinfection
• Patient Care
• Infectious Disease
• Research Projects
• Vendor Decisions
• Construction Renovation Projects

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Any IC Decision is Multifaceted

• APIC SHEA
• CDC Can I take
  my
• JCAHO placenta
  home?
• EPA Can I get AIDS from
• OSHA a razor blade that
• FDA was in a shoe at the
  store?
• CMS What refrigerator can I store
• leeches in?
• State Local Health Department

12
In a Nutshell? Infection Control

• Conductor of Biohazard Safety
• For Patient, Employee, Volunteer, Visitor
• Discussion
• Conclusion
• Recommendation
• Action
• Follow-Up

13
Infection Control The Big Picture

• Site Visits (Surveillance Rounds)
• Prospective Chart Surveillance
• Policy Procedure
• Information Sharing

14
Examples of Big Picture

• September 11, 2001
• Bioterrorism Preparedness
• Smallpox Vaccine
• Anthrax
• Ricin
• Monkey pox For Real!
• SARS
• 2004-2005 Flu Vaccine Shortage

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Our Public Health Commitment

• Extends beyond the hospital
• TB Elimination
• Meningococcal meningitis
• Enteric Pathogens
• Emerging Diseases (SARS)
• The OUTSIDE does
• and will come in it is not
• just business as usual

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Questions ?